2010年镇江市男男性行为者队列基线调查

目的了解江苏省镇江市男男性行为者(men who have sex with men,MSM)艾滋病高危行为特征、感染情况及其影响因素。方法采用分类滚雪球抽样的方法于2010年2—9月,在镇江市范围内招募MSM进行问卷调查,了解其社会人口学及艾滋病高危行为特征,并采集血样进行人类免疫缺陷病毒(HIV)抗体、梅毒抗体、丙型肝炎病毒(HCV)抗体的检测。结果共调查456名MSM,77.0%最近6个月发生过同性口交性行为,其中61.0%有多个同性口交性伴;87.1%最近6个月发生过同性肛交性行为,其中55.3%有多个同性肛交性伴,14.9%最近1周发生过多次同性肛交性行为;11.3%最近6个月与同性发生过商业性行为,34.9%与异性发生过性行为;最近6个月与同性发生口交性行为时坚持使用安全套的比例为16.0%,肛交时坚持使用安全套的比例是40.3%,与同性发生商业性行为时坚持使用安全套的比例是40.0%,与异性发生性行为时坚持使用安全套的比例为26.4%。456名调查者均采集血样进行了血清学检测,初筛HIV阳性人数40人,确证HIV阳性人数35人,阳性率为7.3%(95%CI 5.40%～10.51%);确证梅毒抗体阳性人数为48人,阳性率为10.5%(95%CI7.86%～13.71%);确证HCV抗体阳性人数为2人,阳性率为0.4%(95%CI0.05%～1.58%);确证HIV抗体与梅毒抗体合并阳性人数为4人,合并阳性率为0.9%(95%CI 0.24%～2.23%)。在多因素logistic回归模型中,月收入为1 000～3 000元(OR=0.40,95%CI 0.18～0.87)与HIV感染的关系具有统计学意义。结论镇江市MSM中无保护性性行为较为普遍,HIV和梅毒感染率较高,应在该人群中加强包括艾滋病宣传和安全套推广在内的艾滋病干预措施,控制艾滋病等性传播疾病的流行。

Base-line survey from cohort study among men MSM in Zhenjiang City in 2010

Objective ] To investigate the high-risk behavior, HIV infections and related factors among men who have sex with men {MSM） in Zhenjiang City. Methods] Classified snowball sampling method was employed to recruit MSM for questionnaire survey between February and September in 2010 in Zhenjiang. Data of demographics, risky behaviors were collected and blood samples were tested for HIV, syphilis and HCV infection. Results] Of the 456 MSM surveyed, 77.0% of them had homosexual oral sex in the past 6 months and 61.0% had multiple sexual partners; 87.1% of them had homosexual anal sex in the past 6 months and 55.3% had multiple sexual partners; 11.3% had commercial homosexual activities in the past 6 months; 34.9% had heterosexual sex in the past 6 months. The proportion of condom continuous usage in homosexual oral sex in the past 6 months was 16.0%, which in anal sex was 40.3% and in commercial homosexual activities was 40.0%, while this proportion in heterosexual sex was 26.4%. All 456 survey objects＇ blood samples were collected for serological detection which showed 40 was HIV positive in pre- screening, and 35 were confirmed HIV positive. The positive rate of HIV, syphilis and HCV infection was 7.3 % （ 95 % CI 5.40% - 10.51% ）, 10.5% （95% C17.86%-13.71% ） and 0.4% （95% C17.86% -13.71% ）, respectively. Four MSM were confirmed HIV and syphilis co-infected, the combined positive rate was0.9% （95% CI O. 24%-2.23% }. In multivariate logistic regression model, a monthly income between 1 000-3 000 RMB{ OR =0.40,95% CI O. 18-0.87） were significantly associated with the HIV infection. Conclusion] The unprotected sex is common among MSM in Zhenjiang City, furthermore, the prevalence of HIV infec- tion and syphilis is relatively high, intervention measures such as AIDS propaganda and condom promotion must be strengthened to reduce the HIV spread in such population.